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目的:探讨经腹腔入路腹腔镜手术联合术前介入栓塞在原发性腹膜后肿瘤中的临床应用.方法:回顾分析2019年5月至2021年4月为24例患者行术前介入栓塞联合经腹腔入路腹腔镜原发性腹膜后肿瘤切除术的临床及病理资料,观察术中情况、术后恢复、随访及生存情况.结果:17例行完全腹腔镜腹膜后肿瘤切除术,5例因重要血管骑跨、被肿瘤包绕或粘连严重中转开腹,2例经腹腔镜辅助小切口完成切除术.肿瘤肉眼完整切除(R0/R1)23例,其中6例联合脏器切除;1例腹腔镜探查见多处侵犯无法根治切除,中转开腹行肿瘤部分(R2)切除.手术时间平均(361±137.6)min,术中出血量200(100,575)mL,术后住院7.5(6,9.75)d.术后发生轻度并发症6例,无围术期死亡病例.22例患者获得随访,随访17～40个月,中位随访25.5个月,1例高分化脂肪肉瘤合并粘液样脂肪肉瘤患者于术后24个月复发,予以保守治疗,术后26个月肾衰竭死亡;1例血管平滑肌脂肪瘤,术后21个月因冠心病死亡;余者均无瘤生存.结论:经充分评估后行术前介入栓塞联合经腹腔入路腹腔镜原发性腹膜后肿瘤切除术安全、可行,复杂腹膜后肿瘤建议行术前栓塞治疗.

回顾性分析9例腹腔镜下原发性腹膜后肉瘤切除患者的临床病理资料，结果显示术中3例转开腹，术后无严重并发症，随访8例患者20~114个月，中位随访27.5个月，6例无瘤生存。经充分评估后腹腔镜下原发性腹膜后肉瘤切除是安全有效的。

OBJECTIVE:To evaluate the feasibility and application value of mixed reality technology (MR) in Primary retroperitoneal tumour (PRT) surgery.METHODS:From 276 patients who underwent PRT resection at the First Affiliated Hospital of Xi'an Jiaotong University, we screened 46 patients who underwent MR-assisted retroperitoneal tumour resection and 46 patients who underwent tumour resection without MR assistance. The intraoperative and postoperative recovery of the patients in both groups were compared, and the reliability and validity of the application of MR were further examined using the Likert scale.RESULTS:There was a significant difference in the mean intraoperative bleeding volume between the two groups, but it was reduced in the MR group. The results of the Likert scale showed higher scores in the MR group than non-MR group.CONCLUSIONS:MR can be used to assist PRT resection and has great potential to improve the rate of complete retroperitoneal tumour resection.

Objective:To summarize the clinicopathologic features and clinical diagnosis and treatment experience of retroperitoneal paraganglioma.Methods:This study retrospectively analyzed the clinical, pathological and follow-up data of 39 patients admitted to the First Affiliated Hospital of Xi'an Jiaotong University from 1 Oct 2012 to 1 Oct 2022 for retroperitoneal paragangliomas undergoing resection.Results:There were 19 males and 20 females with tumor being functional in 11 cases (28%) and non-functional in 28 cases (72%). CT angiography showed that the tumors were distributed around the abdominal aorta and inferior vena cava in most cases. All 39 patients underwent tumor rescetion.Patients in laparoscopic group had shorter operation time and postoperative hospital saty compared with open sugery [(135±66)min vs. (194±67)min, t=-2.529, P=0.016; (6.6±2.2)d vs.(9.6±4.8)d, t=-2.096, P=0.043], while there was no statistically significant difference between the two groups in terms of intraoperative blood loss [(152±151)ml vs. (361±608)ml, t=-1.169, P=0.250]. There were no major postoperative complications in the laparoscopic group, and pulmonary infection in 1 case and intestinal obstruction in 1 case in the open group. Thrity-six cases were followed up, ranging from 2 to 115 months, 1 patient in the laparoscopic group died 1 year after surgery due to recurrence and metastasis. In the open group, 1 case recurred 2 years later and was discharged after the second operation, and 1 case died of recurrence 2 years after surgery. Conclusions:Surgery is indicated for retroperitoneal paraganglioma. Adequate perioperative management is the key to the success of the operation. Laparoscopic surgery is superior to open surgery in terms of operation time and postoperative recovery .